Returning to work or school after a brain injury (e.g. traumatic brain injury, stroke, brain tumour, epilepsy, neurosurgery) can be a challenging and stressful process. One of the common mistakes individuals make when returning to work/school is returning too soon, assuming that they are ready once they recover physically. 

After a brain injury, an individual often experiences cognitive difficulties or changes, such as in their memory, attention, speed of thinking, problem-solving skills, judgement, and communication skills, which make it difficult to return to their normal activities and life. Cognitive impairments can take a longer time to recover and rehabilitate compared to physical injuries. Individuals also often experience emotional changes and increased fatigue levels, which make the process even more stressful. 

With proper support, accommodations, and rehabilitation, individuals can successfully transition back to work or school after a brain injury. 

1. Gradual, graded transition

• Returning to work or school too soon can be demoralising and affect an individual’s self-esteem or confidence if their performance is not the same as before. 
• It is recommended that individuals reintegrate back into work or school slowly, and gradually build up to full-time work or school. 
• It may be beneficial to start work on a part-time basis or take on fewer classes at school. For example, an individual can start with a few hours of work daily, or a few days a week, and gradually increase this over time. It is best to begin with working on straightforward and overlearned work tasks, rather than those that are complex, novel or time-pressured.

2. Accommodations

• Individuals post-brain injury may require accommodations to help them to ease back into their work or school environment. Examples include extra time for examinations, deadline extensions, and modified/flexible schedules. 
• Other compensatory strategies that can be helpful include: checklists, calendars, alarm reminders, avoiding multitasking, breaking down tasks into smaller sections, using prompt sheets with step-by-step instructions, and allowing more time than usual to complete tasks. 

3. Managing mood and fatigue

• Mood difficulties, such as feelings of depression and anxiety, can be common after a significant life event such as a brain injury. Poor emotional wellbeing can negatively influence cognitive functioning in daily life as well, such as causing slowness and forgetfulness. 
• Fatigue is commonly experienced after a brain injury. Ensuring regular breaks will aid attention and concentration, and assist in controlling fatigue.
• Avoid undertaking demanding tasks when tired and carry out important tasks at a time of the day where one has the most energy.

4. Seek support

• The right support system can make a successful return to work/school much smoother. 
• Individuals should closely monitor how their work or school performance is once they return, and request for modifications to their schedule if they have difficulty coping. 
• It is important to seek support from family, friends and professionals, to help cope with the emotional and cognitive challenges that come with returning to work or school after brain injury. 
• Rehabilitation provided by neuropsychologists can also improve outcomes after brain injury.

Be patient with yourself and allow your brain the time it needs to recover. Natural recovery and improvement is expected in the first 2 to 3 years post-brain injury. Getting adequate sleep will be essential (at least 8 hours), as well as maintaining a healthy diet and regular exercise in assisting cognitive recovery. 

To meet with a professional psychologist or counsellor, call The Other Clinic at 8809 0659 or email us hello@theotherclinic.sg.